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SCIENCE 



[N. S. Vol. XXXVIII. No. 973 



demonstrated to the congress of that time 

 examples of the disease which he had de- 

 fined as myxcedema, but which, with surer 

 instinct, Gull has described as a cretinoid 

 state in adults. The gradual evolution of 

 the doctrine of thyroid insufficiency and of 

 its therapeutics is a model of induction; 

 and this important discovery has given a 

 great impetus to the whole study of internal 

 secretions, as well as to the employment of 

 organic extracts, of which the last and most 

 interesting is that of the pituitary body. 



The empirical and then the experimental 

 study of small variations in the ordinary 

 diets of adults and children and infants 

 in different social strata and in different 

 countries has been fruitful in many un- 

 expected ways. The great milk problem 

 is still with us, but we have learned the 

 blunders of our early generalizations. 

 Cleanliness in the milk supply from start 

 to finish has a far more exhaustive meaning 

 than in days gone by. The curious disease 

 beri-beri, which some of us have long 

 thought had parallelisms with scurvy, has 

 been shown, at all events amongst rice- 

 eating people, to depend on the loss of the 

 nutritive material just internal to the peri- 

 carp, which the ordinary process of milling 

 removes. 



The patient study of chronic alcoholism 

 has opened up a new chapter in nervous 

 diseases. The routine traditional employ- 

 ment of alcohol in disease has happily been 

 largely discredited. The open-air treat- 

 ment of all forms of tuberculous lesions has 

 had a wide indirect influence, not only on 

 the treatment of other chronic ailments, but 

 on the daily life of the people. 



The recognition and radical treatment of 

 oral sepsis due to damage to the gums in 

 consequence of various disorders of the 

 teeth has been followed by remarkable bene- 

 fit. A strong case has been made out for 

 intestinal stasis as a cause of various forms 



of malnutrition and for operative measures 

 in dealing with slight mechanical obstruc- 

 tions; on this subject we hope for further 

 evidence. 



The additions to diagnosis yielded by 

 x-va.y exploration are like the creation of a 

 sixth sense, and its curative applications 

 and those of radium are the opening of a 

 new chapter of therapeutics. 



I ventured to hint that medicine had now 

 and then led to the rewriting of some chap- 

 ters of physiology, and I may add that re- 

 cent researches on diseases of the heart have 

 led to the reediting of neglected knowledge 

 of the minute structure of heart muscle, 

 and of orderly and disorderly mechanism of 

 its movements. 



Of the magnificent triumphs of the sur- 

 gery of this generation it is beyond my 

 power adequately to speak, but I can refer 

 to the wide fields opened up through the 

 beneficent protection of Listerism. "We are 

 staggered by the reasoned and calculated 

 audacity of our brethren when sinuses of 

 the skull are drained, cerebral abscesses 

 evacuated, cerebral tumors removed, the 

 pituitary body even being investigated, 

 when pleuro-pericardial adhesions are 

 freed, to the great relief of the heart, when 

 different parts of the alimentary canal are 

 short-circuited and when one or other dam- 

 aged viscus is removed either entirely or in 

 part. The active cooperation of surgeons 

 and physicians has gained for us some 

 knowledge of what Moynihan and others 

 have happily described as "living pathol- 

 ogy," and we gratefully acknowledge the 

 invaluable information of correlated symp- 

 toms, signs and morbid conditions, and the 

 statistics of comparative frequency which 

 surgical experience has brought to the com- 

 mon store. 



The supreme gain, after all, is that many 

 more useful lives are saved than in the last 

 generation, that the realm of grave and 



